Chronic osteomyelitis: results of treatment

As stated previously, approximately 8% of the patients evaluated do not require curative treatment and palliative treatment with suppressive therapy may be successful (Fig 2). For the most part, these are C-hosts for whom the morbidity of treatment is greater than the morbidity of disease or exceeds the expected gain. The overall spectrum of treatment in 411 of my patients (1983-1988) is seen in Table 5. Of the 411 patients, 228 (55%) required a bone graft; of these, 42% were primary grafts. Soft-tissue reconstructions were required in 37% of the entire patient population and in 59% of the type IV lesions. The overall amputation rate was 9%. There were no statistical differences in success rates between stable and unstable lesions, nor when cases were stratified for the type or number of bacteria present. However, compromised patients had a statistically inferior prognosis compared with patients who had normal physiologic profiles (Outline 1).